ALL CONTROLLED SUBSTANCES, NOT JUST OXYCONTIN, HAVE POTENTIAL FOR ABUSE

Much has been made by the media of the recent cases of abuse of the drug
Oxycontin. Now we have individuals and state agencies trying to sue the
drug's manufacturer, Purdue Pharma, for creating the problem. As someone
who has practiced in both the fields of addiction as well as pharmacy, I
must say enough already!

The problem is the disease of addiction, not one particular drug or drug
manufacturer. Drug addiction, although recognized as a treatable chronic
disease, still tends to be moralized by many in society.

If we are talking about alcohol, society imposes a "wet moral model,"
meaning it's OK to drink, until you drink too much. Then the individual is
deemed to be immoral, rather than ill. With other drugs, it's a "dry moral
model," meaning any drug use is immoral.

The issue of pharmaceutical drug diversion is not a new phenomenon. In fact
the National Institute on Drug Abuse (NIDA) estimates that there are
roughly 4 million Americans currently abusing prescription drugs. These
drugs, including controlled substances, require a prescription because they
have been determined by the FDA, to be too dangerous to use unsupervised.
Therefore their use requires close medical supervision.

Controlled substances, by their very nature have the potential for causing
addiction. In fact, the DEA schedules them according to their addictive
liability, with schedule II drugs having the greatest risk of addiction.

With opioid narcotic pain relievers, there always will be a risk of
addiction because opioids inherently produce euphoria along with pain
relief. To that end, the drug manufacturers are constantly trying to
develop formulations that provide pain relief, with less associated
euphoric effects.

Oxycontin, when used appropriately every 12 hours, produces significantly
less euphoria than traditional opioids because the active ingredient
oxycodone is released over the 12-hour period. Unfortunately, drug addicts
have figured out how to compromise the long-acting properties of the drug
(with much assistance from the media), so they can get a 12-hour dose
within minutes.

It is true, that even when used appropriately Oxycontin can cause
addiction. The fact that it is a schedule II drug alerts prescribers to
that risk. But addiction can also occur with any of the opioids, schedule
II-V used to treat pain, and in such cases should be viewed as an adverse
event to be monitored for, and dealt with when it occurs.

To say that this problem is unique to Oxycontin is ridiculous. In most
cases however, when addiction does occur, it is because the patient failed
to take the drug as prescribed, or was buying the drug on the street. In
either case, this is not the fault of the drug or its manufacturer.

All the while, as the media hypes the Oxycontin issue, it is estimated that
50 million Americans with chronic pain go untreated everyday. As someone
who treats addicts on a daily basis, I see the personal, family, and
societal problems associated with addiction. As a pharmacist, I also see
the physical and emotional problems associated with untreated pain as well.

Long-acting opioids such as Oxycontin have been true wonder drugs when used
appropriately. Not only can these drugs be effective in giving pain
sufferers their life back, they can also do it with a lower risk of abuse
than what is seen with traditional immediate release products.

While it would be convenient to suggest that the drug is at fault, the
truth is that we as a society are the ones at fault, with our unwillingness
to treat addiction as a disease. Until healthcare professionals are better
trained about addiction, and governments respond with drug treatment
combined with law enforcement, we will continue have a problem with drugs
in this country. Until we treat addiction as a disease, the drug problem
will continue.

Today it is Oxycontin, yesterday it was ecstasy, and before that crack
cocaine and heroin. It's time to start focusing on the solution, drug
treatment, instead of the problems with the drugs themselves.